Drug Resistance Clinical Trial
Official title:
Comparative Evaluation of Aspirin Resistance With Point-of-Care Testing - Danish Aspirin Resistance Trial (DANART) - Pilot Study
Despite treatment with aspirin a large number of patients suffer a myocardial infarction. It has been speculated that these patients might be "resistant" to aspirin, and studies have indicated that this phenomenon is related to a less favourable prognosis. At present, no international consensus exists on how to measure "aspirin resistance". The purpose of this study is to compare different methods for detecting "aspirin resistance". A classic but cumbersome way of evaluating platelet function will be compared to newer, easy-handling point-of-care tests. We hypothesize that one or more point-of-care tests will prove to be superior to the classic platelet function test in detecting aspirin resistance.
Platelets play a major role in arterial thrombus formation - the cause of cardiovascular
death, acute myocardial infarction and ischemic stroke and the number one killer in the
Western World. Binding the COX enzyme platelet aggregation is inhibited by aspirin, and as
prophylaxis against death, myocardial infarction and stroke aspirin is the most widely used
drug worldwide. Low dose aspirin has been shown to improve outcome in patients with ischemic
heart disease, but approximately 12% of these patients will suffer from a vascular event
during a 2 year follow-up period despite aspirin therapy. It has been speculated that these
patients might be "resistant" to the antiaggregatory effect of aspirin, and a diminished
response to aspirin has been correlated with a less favourable outcome. However, at present
no international consensus exists on how to measure "aspirin resistance".
Comparisons: The platelet aggregation in patients with ischemic heart disease on chronic,
low dose aspirin is compared to platelet aggregation i healthy volunteers evaluated with
different tests. The traditional way of evaluating platelet function, Platelet Aggregometry
a.m. Born, will be compared to 3 point-of-care tests (VerifyNow, PFA-100 and Multiplate
Whole Blood Aggregometer) and to urin- and serum thromboxane metabolites as a measure of COX
inhibition.
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Allocation: Non-Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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